Date post: | 24-May-2015 |
Category: |
Health & Medicine |
Upload: | university-of-miami |
View: | 285 times |
Download: | 1 times |
The Epidemiology of Personality and Eating
Disorders
Personality Disorders (PD)
Methodological Issues
Reliability and validity of diagnostic criteria Lack of a “gold standard” to validate diagnosis
Symptoms tend to be part of the individual’s normal experience, so may not be described to interviewer Self-report of certain traits may require insight the
individual does not have Reluctance to self-report of negative traits may result
in under-diagnosis Information should be sought from another person
familiar with the individual being diagnosed
Source: Lyons MJ, Jerskey BA. Personality disorders: Epidemiological findings, methods, and concepts. In: Textbook in Psychiatric Epidemiology, MT Tsuang and M. Tohen (eds.), 2nd edition. New York: Wiley-Liss, Inc., 2002.
Prevalence of Personality Disorders (Overall and Cluster A), NCS-R Study
Any personality disorder: 11.9% Cluster A: 6.2%Paranoid PD: 2.3% (95% CI:0.7%-4.0%)
Schizoid PD: 4.9% (95% CI:0.6%-9.2%)
Schizotypal PD: 3.3% (95% CI:0.0%-7.2%)
Source: Lenzenweger MF, Lane MC, Loranger AW, Kessler RC. DSM-IV personality disorders in the National Comborbidity Survey Replication. Biological Psychiatry 2—7;62(6):553-564.
Prevalence of Personality Disorders (Cluster B), NCS-R Study
Cluster B: 2.3%Antisocial PD: 1.0% (95% CI: 0.0-1.9%)
More common in men than womenBorderline PD: 1.6% (95% CI: 0.3-3.0%)
Histrionic PD: 0.0% (95% CI: 0.0%-1.3%)
Narcissistic PD: 0.0% (95% CI: 0.0-1.3%)
Source: Lenzenweger MF, Lane MC, Loranger AW, Kessler RC. DSM-IV personality disorders in the National Comborbidity Survey Replication. Biological Psychiatry 2007;62(6):553-564.
Prevalence of Personality Disorders (Cluster C)
Cluster C: 6.8%Avoidant PD: 5.2% (95% CI: 2.0-8.3%)
Dependent PD: 0.6% (95% CI: 0.0-1.5%)
Obsessive compulsive PD: 2.4% (95% CI: 0.8-4.0%)
Source: Lenzenweger MF, Lane MC, Loranger AW, Kessler RC. DSM-IV personality disorders in the National Comborbidity Survey Replication. Biological Psychiatry 2—7;62(6):553-564.
Sociodemographic Risk Factors for Personality Disorders
Gender, race/ethnicity, family income, and marital status are not significantly associated with PD in the NCS-R Study Antisocial personality disorder is more common in
men than women Young people and those with less education have the
highest prevalence of Cluster B personality disorders Unemployment is associated with borderline
personality disorder
Source: Lenzenweger MF, Lane MC, Loranger AW, Kessler RC. DSM-IV personality disorders in the National Comborbidity Survey Replication. Biological Psychiatry 2—7;62(6):553-564.
Comorbid Conditions
Individuals with PD have greater odds of anxiety, mood, and impulse-control disorders (axis I disorders)
Source: Lyons MJ, Jerskey BA. Personality disorders: Epidemiological findings, methods, and concepts. In: Textbook in Psychiatric Epidemiology, MT Tsuang and M. Tohen (eds.), 2nd edition. New York: Wiley-Liss, Inc., 2002.
Eating Disorders
Lifetime Prevalence of Eating Disorders, NCS-R Study
Anorexia nervosa Men: 0.3%; Women: 0.9%
Bulimia nervosa Men: 0.5%; Women: 1.5%
Binge eating disorder Men: 2.0%; Women: 3.5%
Subthreshold binge eating disorder Men: 1.9%; Women: 0.6%
Source: Hudson JI, Hiripi E, Pope HG, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry 200;61:348-358.
12-Month Prevalence of Eating Disorders, NCS-R Study
Bulimia nervosaMen: 0.1%; Women: 0.5%
Binge eating disorderMen: 0.8%; Women: 1.6%
Subthreshold binge eating disorderMen: 0.8%; Women: 0.4%
Source: Hudson JI, Hiripi E, Pope HG, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry 200;61:348-358.
Median Age of Onset
Source: Hudson JI, Hiripi E, Pope HG, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry 200;61:348-358.
Anorexia nervosa 18.0 years
Bulimia nervosa 18.0 years
Binge eating disorder 21.0 years
Subthreshold binge eating disorder 20.0 years
Median Years with Episode
Source: Hudson JI, Hiripi E, Pope HG, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry 200;61:348-358.
Anorexia nervosa 1.0 years
Bulimia nervosa 5.0 years
Binge eating disorder 4.0 years
Subthreshold binge eating disorder 2.0 years
12-month Persistence
Source: Hudson JI, Hiripi E, Pope HG, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry 200;61:348-358.
Anorexia nervosa 0%
Bulimia nervosa 30.6%
Binge eating disorder 44.2%
Subthreshold binge eating disorder 47.2%
Comorbid Conditions
Source: Hudson JI, Hiripi E, Pope HG, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry 200;61:348-358.
Individuals with a lifetime diagnosis of anorexia nervosa had a significantly lower BMI than those without any eating disorder
Individuals with a lifetime diagnosis of binge eating disorder had a higher prevalence of BMI ≥40 relative to respondents without any eating disorder
Eating disorders are associated with mood, anxiety, impulse-control, and substance use disorders